1. Field of the Invention
This invention relates to operation of x-ray fluoroscope devices during surgery and more particularly, to a head-activated fluoroscopic control which includes a transmitter for transmitting partially collimated, continuous wave electro-magnetic radiation such as infrared radiation, and a receiver for receiving the electromagnetic radiation. The transmitter is located in a small cartridge adapted for mounting on the eyeglasses, headband or alternative headpiece of a surgeon or assisting physician and the receiver includes an electromagnetic detection circuit combined with a phase-lock type frequency detector which is tuned to the frequency of the electromagnetic radiation emitted by the transmitter. The receiver may be either located in close proximity to a fluoroscope monitor, or built into the monitor, while the fluoroscope is typically characterized by a C-arm unit having an x-ray tube and beam collimator positioned above the operating table and an image intensification unit located beneath the operating table to facilitate operation of the fluoroscope responsive to turning of the surgeon or attending physicians' head toward the fluoroscope monitor and transmission of the electromagnetic radiation in a partially collimated beam from the transmitter to the receiver.
The use of fluoroscopic radiation is widespread in many surgical procedures, as well as diagnostic testing performed in medical centers around the world. Activation of the fluoroscopic x-ray energy is traditionally initiated by a surgeon or attending physician using a foot-operated switch. Because the foot-operated switch is located on the floor beneath the operating table where it cannot be easily viewed by the surgical team, it may be accidentally activated by one or more members of the team during the surgical procedure. Furthermore, conductive body fluids may be spilled on the foot switch during the procedure, thereby causing it to malfunction. Moreover, it may be difficult for some physicians to operate the foot switch due to personal handicaps and the foot switch may be easily accidentally activated for an excessive period of time due to distractions in the operating room. The activation of fluoroscopic x-ray energy due to any one of the above circumstances results in useless, unnecessary and sometimes dangerous ionizing exposure to the patient. From observations of fluoroscopic procedures, it has been observed that up to 10% of the fluoroscopic x-ray time used during an average surgical procedure is non-productive. In practice, any needless x-ray exposure to patients or hospital workers should be avoided since the ionizing effect of x-rays to the body are cumulative. Accordingly, the head-activated fluoroscopic control of this invention facilitates a highly satisfactory technique for using fluoroscopic radiation on demand in an optimum manner by the surgeon or attending physician without needless x-ray exposure to the patient and without the necessity of using the hands or feet of the surgeon or attending physician.
Upon analyzing the problem of more efficient use of fluoroscopic radiation in surgical procedures, it was noted that the physicians or surgeons do not need fluoroscopic x-ray until their eyes are focused on the fluoroscopic x-ray monitor. A continuous wave, compact infrared source cartridge was devised which is sufficiently small and light to be clipped or otherwise attached to eyeglasses, a headband or an alternative headpiece. A highly sensitive infrared detection circuit, combined with a phase-lock type frequency detector tuned to the frequency of the transmitter, was also developed as a receiver to detect the partially collimated infrared beam emitted by the transmitter cartridge. Using a combination of source beam and detector collimation and by adjusting the overall system sensitivity, an optimum triggering zone was created which allows accurate activation of the fluoroscopic x-ray, thus minimizing the unintentional fluoroscopic radiation which a patient often receives during surgery. The device also eliminates the necessity for using an awkward foot switch located on the floor beneath the operating table. The receiver is mounted on or in close proximity to the fluoroscopic x-ray monitor, which faces the area where the assisting or attending physician or surgeon normally stands during an operating room procedure and the relay contacts of the receiver are attached in parallel to the normal fluoroscopic x-ray foot switch contacts. During a typical fluoroscopic x-ray procedure, whenever the physician turns his head toward the monitor, a partially collimated, cone-shaped transmitter beam continuously emitted from the transmitter cartridge strikes the receiver and the fluoroscopic x-ray device is activated as if the conventional foot switch had been pressed. The beam collimation adjustment in the transmitter is such that the physician's line of sight must be directly at the fluoroscopic x-ray monitor to activate the receiver and energize the fluoroscope device. Conversely, when the physician turns his head away from the monitor the beam no longer strikes the receiver and operation of the fluoroscope device is terminated.
3. Description of the Prior Art
Various types of remote control switching systems are known in the art. An electro-optical switching system is detailed in U.S. Pat. No. 4,091,273, dated May 23, 1978, to William D. Fuller, et al. The system includes multiple visually activated switches, one for each one of a plurality of different electronic apparatus, each including electromagnetic radiation sensors having a detection surface and each controlling the application of electrical power to the respective equipment in response to an impinging electromagnetic beam incident at the detection surface for a determined time interval. A pulsed electromagnetic beam is provided by a transmitter included within an electrical magnetic activating source which is held or disposed on a portion of the anatomy of the human operator, who aligns the beam with the detection surface on the selected one of the switches with the aid of a visual reticle image provided by a reticle generator included in the activating source and boresighted with the transmitter. The system further includes a control unit responsive to each of the radiation sensors for discriminating between the pulsed electromagnetic beam energy and the ambient energy background and for providing actuating signals to the respective equipment in response to the presence of incident pulsed electromagnetic energy at the associated visually activated switch detection surface for a determined time interval in the absence of incident pulsed electromagnetic energy at each of the other switches within the same time interval, the control unit providing actuation of the various selected equipment sequentially, one at a time. A "Remote Control Device for Operation by Radiation" is detailed in U.S. Pat. No. 4,156,134, dated May 22, 1979, to Willy Minner. The device operates by means of radiation and includes a receiver for the radiation and means for transforming the radiation into an electric signal, as well as rectification means for rectifying an electric signal. U.S. Pat. No. 4,377,006, dated Mar. 15, 1983, to Johnny Collins, et al, details an "IR Remote Control System". The remote control system is designed for a television receiver and includes a transmitter and a receiver, the transmitter being adapted for transmitting a multibit code identifying a selected function of the television receiver, wherein the data bits forming the multibit code each include a single pulse representing a first logic state and a grouping of at least two relatively close spaced pulses representing a second logic state. The remote control receiver includes a self-locking detector for converting the transmitted pulses to a binary logic signal and decoding apparatus responsive to the logic signal for operating the selected television receiver function. U.S. Pat. No. 3,475,092, dated Oct. 28, 1969, to D. M. Harvey, details a "Wireless Remote Control Slide Changer". The device is designed for selectively actuating a forward and reverse changing mechanism of a projector such as a slide projector. The system includes a hand-held control unit which develops a pulse length modulated beam of actinic radiation for energizing a photosensitive receiver mounted on the slide projector. The beam of light is chopped by using an alternatively opaque and transparent rotating or vibrating grate. An elevator remote-control apparatus is detailed in U.S. Pat. No. 4,673,911, dated June 16, 1987, to K. Yoshida. The remote control apparatus is designed such that when a desired call has been registered with the "up" button or "down" button of a remote controller, an acceptance signal is delivered from an elevator control device to turn the "up" button or "down" button of the hall button device on. At the same time, a response signal corresponding to the acceptance signal is sent from the transmitter of the hall button device to the remote controller and it is received by the receiver of the remote controller, to activate the response lamp in correspondence with the call registration. Accordingly, the ascent or descent registration of an elevator can be reliably acknowledged on the remote controller side.
It is an object of this invention to provide a head-activated fluoroscopic x-ray control system which eliminates the requirement of a conventional foot switch in operating a fluoroscopic x-ray and monitor.
Another object of the invention is to provide a head-activated fluoroscopic control which is characterized by a partially collimated beam source for transmitting continuous wave electromagnetic radiation and a receiver device to detect the radiation beam and actuate a set of relay contacts to selectively operate a fluoroscopic x-ray and monitor.
Yet another object of this invention is to provide a head actuated control system for operating a fluoroscope during operating room procedures, which system includes a head-mounted transmitter cartridge capable of emitting a continuous cone-shaped beam of infrared radiation and an infrared receiver mounted in or located in close proximity to a fluoroscope monitor for receiving the beam and activating the fluoroscope.
Still another object of the invention is to provide a head activated control system for a fluoroscope, and a C-arm fluoroscope in particular, which control system includes an infrared emitter cartridge capable of emitting a continuous, partially collimated, cone-shaped beam of infrared radiation and a receiver built into or resting on the fluoroscope monitor, which receiver is provided with an infrared detection circuit for receiving the infrared radiation and triggering operation of the fluoroscope responsive to moving the head and viewing the monitor.
A still further object of this invention is to provide an infrared transmitter adapted for mounting on the eyeglasses, headband or alternative headpiece of a surgeon or attending physician, for emitting a continuous, partially collimated infrared beam and an infrared receiver positioned in close proximity to a fluoroscopic x-ray monitor for receiving the collimated infrared beam and activating a fluoroscopic x-ray device located over an operating table.
Another object of the invention is to provide a head-activated fluoroscopic control which includes a cartridge transmitter capable of transmitting a continuous wave source of partially collimated infrared radiation and provided with a light weight cable, which transmitter can be adapted to mount on a headband, goggles, eyeglasses or an alternative headpiece and further including a highly sensitive infrared detector mounted on, in or near a fluoroscopic x-ray monitor, wherein the collimated beam emitted by the transmitter is received by the receiver responsive to turning of the surgeon's or physician's head toward the monitor, in order to activate the fluoroscopic x-ray and monitor.